Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 003983 | MO |
NPI | 1053457903 |
---|---|
Provider Name | Mrs. Linda K Heinze |
First Address | Ballwin, MO 63021-5899 |
Second Address | Florissant, MO 63031-5108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 26/07/2007 |